Advancement in our understanding of immune response against Encephalitozoon infection.

Microsporidia are a group of obligate, intracellular, spore-forming eukaryotic pathogens, which predominantly infects immunocompromised individuals worldwide. Encephalitozoon spp. is one of the most prevalent microsporidia known to infect humans. Host immune system plays a major role in combating pathogens including Encephalitozoon spp. infecting humans. Both innate and adaptive arms of host immune system work together in combating Encephalitozoon infection. Researchers are conducting studies to elucidate the role of both arms of immune system against Encephalitozoon infection. In addition to cell-mediated adaptive immunity, role of innate immunity is also being highlighted in clearance of Encephalitozoon spp. from host body. Therefore, the current review will give a clear and consolidated update on the role of innate as well as adaptive immunity in protection against Encephalitozoon spp.

Acanthamoeba and its pathogenic role in granulomatous amebic encephalitis.

Acanthamoeba is a free-living amoeba that is widely distributed in the environment. It is an opportunist protist, which is known to cause rare yet fatal infection of the central nervous system (CNS), granulomatous amebic encephalitis (GAE) in humans. GAE cases are increasingly been reported among immunocompromised patients, with few cases in immunocompetent hosts. Diagnosis of GAE primarily includes neuroimaging, microscopy, cerebrospinal fluid (CSF) culture, histopathology, serology and molecular techniques. Early diagnosis is vital for proper management of infected patients. Combination therapeutic approach has been tried in various GAE cases reported worldwide. We tried to present a comprehensive review, which summarizes on the epidemiology of GAE caused by Acanthamoeba along with the associated clinical symptoms, risk factors, diagnosis and treatment of GAE among infected patients.

Nanoparticles based therapeutic efficacy against Acanthamoeba: Updates and future prospect.

Acanthamoeba sp. is a free living amoeba that causes severe, painful and fatal infections, viz. Acanthamoeba keratitis and granulomatous amoebic encephalitis among humans. Antimicrobial chemotherapy used against Acanthamoeba is toxic to human cells and show side effects as well. Infections due to Acanthamoeba also pose challenges towards currently used antimicrobial treatment including resistance and transformation of trophozoites to resistant cyst forms that can lead to recurrence of infection. Therapeutic agents targeting central nervous system infections caused by Acanthamoeba should be able to cross blood-brain barrier. Nanoparticles based drug delivery put forth an effective therapeutic method to overcome the limitations of currently used antimicrobial chemotherapy. In recent years, various researchers investigated the effectiveness of nanoparticles conjugated drug and/or naturally occurring plant compounds against both trophozoites and cyst form of Acanthamoeba. In the current review, a reasonable effort has been made to provide a comprehensive overview of various nanoparticles tested for their efficacy against Acanthamoeba. This review summarizes the noteworthy details of research performed to elucidate the effect of nanoparticles conjugated drugs against Acanthamoeba.

Prevalence and Genetic Characterization of Cryptosporidium and Microsporidia Infecting Hematological Malignancy Patients.

PURPOSE: To evaluate the prevalence of Cryptosporidium and Microsporidia, associated risk factors and species identification in patients with haematological malignancies (HM). METHODS: A total of 148 consecutive patients with HM and 101 healthy subjects were evaluated for Cryptosporidium and Microsporidia using modified Kinyoun and modified Trichrome staining. Clinical, demographic and laboratory parameters were studied. The species of Cryptosporidium and Microsporidia were studied using PCR-RFLP. RESULTS: Of 148 HM patients initially screened, 47 were excluded from the final analysis due to inadequate clinical records. Patients with HM [n = 101, 63 (62.4%) male] more often had Cryptosporidium than healthy subjects [n = 101, 65 (74.4%) male] [3/101 (3%) vs. 0/101 (0%), p = 0.02]. Two of 101 (2%) HM patients and none of the healthy subjects had Microsporidia (p = 0.155). Diarrhea was more prevalent in HM patients with Cryptosporidium than those without [3, 100% vs. 39/96, 40.62%; p = 0.04). Both patients infected with Microsporidia presented with persistent diarrhea and fever. Cryptosporidium hominis was identified in all the three HM patients. Enterocytozoon bieneusi was identified in one HM patient infected with Microsporidia, which was classified as genotype Ind2. CONCLUSION: Cryptosporidium and Microsporidia may infect HM patients leading to overwhelming diarrhea. The commonest species of Cryptosporidium and Microsporidia found to infect HM patients are C. hominis and E. bieneusi.

Evaluation of the Antimicrobial Efficacy of Herbal Extracts Added to Root Canal Sealers of Different Bases: An In Vitro Study.

AIM: This study aimed to evaluate and compare the antimicrobial efficacy of root canal sealers of different bases when mixed with herbal extracts. MATERIALS AND METHODS: An evaluation of three sealers (Endomethasone, AH plus, Apexit plus) mixed with three herbal extracts [Emblica officinalis (Amla), Myristica fragrans (Nutmeg) and Salvadora persica (Miswak)] was done against nine strains of bacteria at various time intervals using the agar diffusion test. Moreover, measurement of the mean zones of inhibition was done. RESULTS: The largest zones of bacterial growth inhibition were observed with Endomethasone mixed with Myristica fragrans (Nutmeg) followed in the descending order by AH plus mixed with Salvadora persica (Miswak) and Apexit plus mixed with Salvadora persica (Miswak) respectively. The differences between zones of inhibition among different groups were found to be statistically significant. CONCLUSION: Zinc-oxide-eugenol-based sealer (Endomethasone) mixed with herbal extracts produced the largest inhibitory zones followed in the descending order by resin-based sealer (AH plus) and calcium-hydroxide-based sealer (Apexit plus), respectively. CLINICAL SIGNIFICANCE: Herbal plants such as [Emblica officinalis (Amla), Myristica fragrans (Nutmeg) and Salvadora persica (Miswak)] are rich sources of bioactive compounds that possess antimicrobial properties. Mixing their extracts with endodontic sealers can produce additive antimicrobial effect against microbes found in inflamed pulp. HOW TO CITE THIS ARTICLE: Devi MT, Saha S, Tripathi AM, et al. Evaluation of the Antimicrobial Efficacy of Herbal Extracts Added to Root Canal Sealers of Different Bases: An In Vitro Study. Int J Clin Pediatr Dent 2019;12(5):398-404.